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"Tujuan penelitian ini adalah mengetahui prevalensi hipertensi sistolik terisolasi (HST) pada populasi berusia 40 tahun ke atas di Indonesia serta faktor-faktor risiko yang ada.Metode : Desain penelitian adalah potong lintang; subyek diperoleh dari pasien yang berobat ke dokter dan keluarga atau pengantar mereka. Dokter terpilih secara acak dari 11 kotamadya dan 11 kabupaten yang terpilih secara acak (systematic random sampling assignment) dari lima pulau besar Indonesia dan satu kepulauan Maluku. Nilai pengukuran tekanan darah menggunakan nilai baku dari 3NC VII tahun 2003.Hasil : Subyek yang terkumpul adalah 4436 orang dan HST terdapat pada 316 subyek. Faktor yang berpengaruh terhadap HST adalah umur (OR 1,06 ; 95%CI 1,06 - 1,07), riwayat DM (OR 1,44 ; 95%CI 1,04 - 2,02) , dan riwayat gagal ginjal (OR 1,71 ; 95%CI 0,99 - 2,94). Pada subyek yang merokok, rerata lama merokok yang menderita HST adalah 28,78±14,45 bulan sedangkan yang tidak menderita HST adalah 22,33±11,80 bulan (p = 0,003).Kesimpulan : Prevalensi HST adalah 7,12%. Terdapat hubungan antara umur, riwayat DM dan gagal ginjal dengan HST. Pada penelitian ini tidak terdapat hubungan antara merokok, riwayat keluarga dengan hipertensi dan indeks massa tubuh dengan HST. Pada subyek yang merokok, ternyata lama merokok berbubungan dengan kejadian HST.Daftar pustaka: 37 (1994-2003).

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Isolated Systolic Hypertension in Indonesia, Prevalence and Risk FactorsObjective of this study was to examine the prevalence of isolated systolic hypertension (ISH) amongst Indonesia people at the age of 40 years and over with its associated risk factors.

Methods: Cross sectional study; subjects were collected from persons who visited their doctors or their families. Doctors participated in this study were randomly assigned from 11 cities and 11 district area at five big islands and archipelago also in a systematic random sampling assignment. Measurement of blood pressure were using the standard procedure stated in INC VII (2003).

Results: Of the 4436 subjects, 316 persons met the criteria of ISH. Factors associated with ISH were age (OR 1.06 ; 95%CI 1.06 - 1.07), history of DM (OR 1.44 ; 95%CI 1.04 - 2.02) , and history of renal failure (OR 1.71 ; 95%CI 0.99 - 2.94). Amongst subjects who were smoking, mean duration of smoking in ISH persons was 28.78±14.45 months while in non-ISH persons was 22,33±11,80 months ( p = 0.003).

Conclusion: The prevalence of ISH was 7.12%. Age, history of DM and history of renal failure were associated with ISH. There were no association between smoking, family history of hypertension and body mass index with ISH in this study. Amongst smoking subjects, the duration of smoking was associated with ISH.

References: 37 (1994-2003)"

"A complaint of unwillingness to eat in the elderly is often overlooked, both by the patient, the family, or the doctor. Such condition may have a more serious underlying background, such as infection. A reduced physiological deposit and different clinical manifestations gives importance lo the analysis of the problem of anorexia. Changes in body composition, reduced physical activity and basal metabolism rate, reduced Na+-Kl~-ATP-ase, teeth that are no longer in optimal condition, reduced taste and smell ability, increased CCK satiation effect, reduced gastric emptying, reduced NO-synthase activity of the gastric fundus, as well as reduced endogenous opioid level, could all influence the development of anorexia. In addition, there are also several other clinical conditions that play a role, such as polypharmacy, dementia, depression, and physiological disturbance in swallowing."

"Background: the National Health Insurance (NIH/JKN) has been enacted since January 2014. Various outcomes of geriatric patient care, such as improved functional status and quality of life have not been evaluated. Prolonged hospitalization and re-hospitalization are potentially affecting the efficiency care of this vulnarable group. This study aimed to identify the differences of functional status improvement, quality of life improvement, length of stay, and hospitalization of geriatric patients admitted to CMH between prior to and after NHI implementation. Methods: a cohort study with historical control was conducted among geriatric patients admitted to Acute Geriatric Ward CMH Hospital on two periods of time: January-December 2013 (pre-NHI implementation) and June 2014-May 2015 (after NHI implementation). Patients who died within 24 hours of hospital admission, those with APPACHE II score >24, advance stage cancer, transfer to other wards before they were discharged or have incomplete record were excluded from the study. Data on demographical and clinical characteristics, functional status, quality of life, length of stay, and re-hospitalization were taken from patient’s medical record. The differences of studied outcomes were analyzed using t-test or Mann-Whitney test. Results: there were 102 subjects in pre-NHI and 135 subjects in NHI groups included in the study. Median lengths of stay were not different between two groups (12.5 days in pre-NHI and 10 days in NHI groups, p=0.087), although the proportion of patients with in-hospital stay less than 14 days was higher in NHI group. The difference of functional status of discharged patients in pre-NHI and NHI groups were 3 and 3 (p=0.149) respectively, whereas for health-related quality of life, although NHI group in the beginning showed a lower quality of life compared to the pre-NHI (0.163 [0.480] vs. 0.243 [0.550]; p=0.012). However, after incorporating comprehensive geriatric assessment (CGA) the quality of life improved significantly by the end of in-hospital care in both groups. Re-hospitalization incidence in NHI group was lower compared to pre-NHI (7 [5.2%] vs. 13 [12.7%]; p=0.038). Conclusion: our study shows that there was no significant difference regarding length of stay, functional status, and health-related quality of life between prior to and after national health insurance implementation on admitted geriatric patients. Rehospitalization incidence showed better results in NHI group and hence NHI implementation is favored.

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Latar belakang: jaminan kesehatan nasional telah diberlakukan sejak Januari 2014. Berbagai keluaran perawatan pasien geriatri, misalnya perbaikan status fungsi dan kualitas hidup, belum pernah dinilai sebelumnya. Perawatan di rumah sakit yang lama dan kejadian rawat inap ulang di rumah sakit berpotensi mempengaruhi efisiensi keperawatan kelompok yang rentan ini. Tujuan dari penelitian ini untuk mengenali perbedaan perbaikan status fungsi, perbaikan kualiltas hidup, lama rawat inap di rumah sakit dan perawatan di rumah sakit pada pasien-pasien geriatri yang dirawat di RSCM sebelum dan sesudah program JKN diterapkan. Metode: suatu penelitian kohort dengan kontrol historis pada pasien-pasien geriatri yang dirawat di Bangsal Geriatri Akut RSCM dilakukan dalam dua periode waktu: Januari–Desember 2013 (sebelum penerapan JKN) dan Juni 2014–Mei 2015 (setelah penerapan JKN). Pasien yang meninggal dalam waktu 24 jam setelah rawat inap dan pasien dengan skor APPACHE II >24, dengan kanker stadium lanjut, dipindahkan ke bangsal lain sebelum keluar dari rumah sakit atau pasien tanpa rekam medik yang lengkap disingkirkan dari penelitian. Data demografi, karakteristik klinik, status fungsional, kualitas hidup, lama rawat inap dan rawat inap ulang didapat dari rekam medik pasien. Perbedaan keluaran yang diteliti dianalisis menggunakan uji t atau uji Mann-Whitney. Hasil: terdapat 102 subjek pada kelompok praJKN dan 135 subyek pada kelompok JKN dalam penelitian ini. Nilai median lama perawatan tidak berbeda antara kedua kelompok (12,5 hari pada kelompok pra-JKN dan 10 hari pada kelompok JKN, p=0,087), meskipun demikian proporsi pasien dengan lama rawat inap di RS kurang dari 14 hari tampak lebih tinggi pada kelompok JKN. Perbedaan status fungsional pasien yang keluar dari rumah sakit pada kelompok pra-JKN dan kelompok JKN adalah 3 dan 3 (p=0,149) untuk masing-masing kelompok; sedangkan untuk kualitas hidup terkait kesehatan, meskipun kelompok JKN pada awalnya menunjukkan kualitas hidup yang lebih rendah daripada kelompok pra-JKN (0,163 [0,480] dibandingkan 0,243 [0,550]; p=0,012), tetapi setelah dilakukan Pengkajian Paripurna pada Pasien Geriatri (P3G)/ comprehensive geriatric assessment (CGA), terdapat perbaikan kualitas hidup yang bermakna saat akhir perawatan di rumah sakit pada kedua kelompok. Insidens rawat inap ulang pada kelompok JKN lebih rendah daripada kelompok praJKN 7 [5,2%] dibandingkan 13 [12,7%]; p=0,038). Kesimpulan: penelitian ini menunjukkan bahwa tidak terdapat perbedaan bermakna dalam hal lama rawat inap, status fungsional serta kualitas hidup terkait kesehatan antara sebelum dan sesudah penerapan Jaminan Kesehatan Nasional pada pasien geriatri yang dirawat. Insidens rawat inap ulang tampaknya lebih baik pada kelompok JKN sehingga penerapan JKN menjadi lebih disukai"